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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />_ �'i� Woa� �mcsz. <br />PROJECT ADDRESS <br />M�k.� u�,�-N��. s' 409 wc�L. PI«ce Fz� t,Tc. `��4 4zS -3y1� <br />OWner Mail Address Ciry SUte2ip Phone <br />Tenant <br />Mail Address <br />Cily <br />Stale/Zlp <br />Phone <br />P��-a� Cl��-�� ..i�-. z73a �.�� E��•�-, c,�n 9��3 4zs-3.4a•-�3o <br />Etectrical Contraclor Mail Address City State2ip Phone <br />P��s � c-r �s�� c,� <br />State License Number <br />S. C. �Z. <br />Proposed Use o( Building <br />F�, <br />Contract Price of Work <br />Cantacl Person (Plan Review) <br />Descriplion of Work to Be Done: 1�.6'f'Q,ll Izl'lV �': 2�_�-�— M-a'f' `�z� �n <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 5105 <br />FEE <br />1 hereby certily Niaf I have read and examined this epplication and know fhr same to 6o true and <br />correcf. All provisions ollaws and ordinanr.es governing fhis type ol work will be completed <br />whether speci(ed herein or nof. The granting o/a pemut does nol presume fo give authorify to <br />violate or cancel fhe provisions olany ofher sfafe or locallaw regulafing construction or fhe <br />peAomiance o/ consfruction. That 1 am authorized by the owner o/ fhis property to perlorm fhe <br />work lor which applicalion is made and I comply wifb fhe State Confreclors Law 18.27 RC W and <br />296.200 WAC. <br />� `"-�-. _ �ca.s i( � � ' � %J `Gi � <br />Si�nature ate <br />�aSaG -ii9 <br />